Table of Contents
ISRN Hepatology
Volume 2013, Article ID 174608, 8 pages
http://dx.doi.org/10.1155/2013/174608
Clinical Study

Selective Arterial Embolization of Liver Metastases from Gastrinomas: A Single-Centre Experience

1Department of Surgery, Academic Medical Center, Meibergdreef 9, P.O. Box 22660, 1105 AZ Amsterdam, The Netherlands
2Department of Medical Oncology, Academic Medical Center, Meibergdreef 9, P.O. Box 22660, 1105 AZ Amsterdam, The Netherlands
3Department of Intervention Radiology, Academic Medical Center, Meibergdreef 9, P.O. Box 22660, 1105 AZ Amsterdam, The Netherlands

Received 22 May 2013; Accepted 7 July 2013

Academic Editors: A. Granito and H. Malik

Copyright © 2013 Anneke P. J. Jilesen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Gastrinomas are rare functional neuroendocrine tumors causing the Zollinger-Ellison syndrome (ZES). At presentation, up to 25% of gastrinomas are metastasized, predominantly to the liver. Embolization of liver metastases might reduce symptoms of ZES although a postembolization syndrome can occur. In this study, the results of embolization are presented, and the literature results are described. Methods. From a prospective database of pancreatic neuroendocrine tumors, all patients with liver metastatic gastrinomas were selected if treated with arterial embolization. Primary outcome parameters were symptom reduction, complications, and response rate. The literature search was performed with these items. Results. Three patients were identified; two presented with synchronous liver metastases. All the three patients had symptoms of ZES before embolization. Postembolization syndrome occurred in two patients. Six months after embolization, all the 3 patients had a clinical and complete radiological response; a biochemical response was seen in 2/3 patients. From the literature, only a small number of gastrinoma patients treated with liver embolization for liver metastases were found, and similar results were described. Conclusion. Selective liver embolization is an effective and safe therapy for the treatment of liver metastatic gastrinomas in the reduction of ZES. Individual treatment strategies must be made for the optimal success rate.